Multiple non-caseating uniform granulomas, suspicious of sarcoidosis

Beryllium exposure by occupational history


Brief Discussions

Chronic beryllium ds

Berylliosis caused by exposure to aerosols, dusts, or fumes of beryllium metal or salts

Systemic granulomatous disease

Histologic features identical to sarcoidosis

Thought to be caused by a specific, cell-mediated hypersensitivity response to long-term exposure to beryllium

Symptoms : Exertional dyspnea (m/c), cough, chest pain
 

Diagnosis

Suggested by a history of significant exposure to beryllium

Consistent radiographic findings

Abnormal PFT

Confident diagnosis : demonstration of granulomas in tissue, and  a proliferative response of lymphocytes obtained by BAL to beryllium (bronchoalveolar lymphocyte transformation test )

Radiographic findings

Small round and reticular opacities that are distributed diffusely in the lungs without zonal predominance(m/c)

Linear scars, bulla, fibrosis predominantly involving the upper lobes

Conglomerate masses similar to those seen in silicosis

Hilar lymphadenopathy : in up to 1/3 of affected patients

Pleural thickening

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